HealthRise India Program Launch

Transcription

1 HealthRise India Program Launch MAMTA Health institute for Mother and Child Grantee & CAC Kick-Off Meetings November 19-20, 2015 New Delhi, India

2 Outline About MAMTA HealthRise Objectives & Target Beneficiaries Problem Statement Intervention Framework and Key Activities Key Partners Key Project Staff Timeline for next 6 months 12/8/2015 A Medtronic Philanthropy Healthcare Access Program 2

3 VISION Working together in building a world that is just, equitable and inclusive About MAMTA Brief introduction KEY THEMES SRHR MNCH&N HIV/AIDS & TB NCDs STRATEGIES Community action Capacity building Research & Evidence Building Systems strengthening Networking & Collaboration Key Collaborations and Partnerships over 10 years: AUSAID Ministry of Health and Family Welfare, GOI DFID Ministry of Women and Child, GOI European Union Ministry of Youth Affairs and Sports, GOI Finland Development Aid National Institute for Urban Affairs Foundations : National AIDS Control Organisation (NACO) (EJAF, Packard Foundation, Ford Foundation, BMGF, McArthur) State AIDS Control Society (SACS) IPPF Ministry of Panchayati Raj, GOI International HIV/AIDS Alliance National Commission for Women, GOI SAARC/SAIVAC National Health Mission, Flagship Programme, GOI USAID National Institute of Health and Family Welfare (NIHFW) UN agencies (UNDP, UNAIDS, UNICEF, UNFPA, WHO) NIPCCD Corporate Partnerships ` BIRAC-BMGF-DBT 3

4 Health Rise India Overall Objectives 1- Increasing screening and diagnosis (detection) of people who have not been diagnosed and are not aware that they are suffering from diabetes or hypertension but are at risk for either disease by July Increasing management and control of Diabetes or Cardio Vascular Diseases (particularly hypertension) by July 2018.

5 Target Beneficiaries A. Individuals of years age group from rural and urban areas who belong to following categories: a. At risk individuals of diabetes and CVD b. Individuals living with diabetes/hypertension and not meeting their clinical targets (FBS, HbA1c, total cholesterol) c. Individuals living with diabetes/hypertension with co-existing morbidity or complication (nephropathy/neuropathy/retinopathy) B. Health workforce: a. Healthcare providers - Doctor and Nurse b. Frontline functionaries. C. Family and caregivers 5

6 Outline Problem Statement - Burden - Access to care 12/8/2015 A Medtronic Philanthropy Healthcare Access Program 6

7 Problems Burden of Disease, Shimla NCD STATUS* Diseases Hypertension (29.2%) Diabetes (3.3%) Ever Diagnosed Undiagnosed Ever Diagnosed Undiagnosed (30%) (70%) (81%) (19%) On treatment (26%) Not on Treatment (4%) On treatment (76%) Not on Treatment (5%) Controlled Uncontrolled Controlled Uncontrolled (9%) (17%) (37%) (39%) *Source : Health Rise Needs Assessment Overview India: Shimla and Udaipur. Institute for health metrics and evaluation. Mar

8 Problems Access to NCD care Perceived by the community Reluctance towards self-care Financial problem Lack of knowledge about diseases Lack of knowledge about services Fear to visit Hospital alone Expensive health care Overcrowded health facilities Unavailability of doctor Long waiting time Lack of laboratory facilities Improper attention of the health care staff Lack of space Hectic process of collecting lab-reports Medicines are not free Timings of health facility are not convenient Improper infrastructure Lack of specialist doctor Lack of positive attitude Long distance from home to health facility Poor transportation facility Lack of family/community support Inability to take decision independently due to family/ culture

9 Problems Access to NCD care Perceived by the community Reluctance towards self-care Financial problem Lack of knowledge about diseases Lack of knowledge about services Fear to visit Hospital alone Expensive health care Overcrowded health facilities Unavailability of doctor Long waiting time Lack of laboratory facilities Improper attention of the health care staff Lack of space Hectic process of collecting lab-reports Medicines are not free Timings of health facility are not convenient Improper infrastructure Lack of specialist doctor Lack of positive attitude Long distance from home to health facility Poor transportation facility Lack of family/community support Inability to take decision independently due to family/ culture

10 Lens 1 Individual Factors Reluctance towards self-care Financial problem Lack of knowledge about diseases Lack of knowledge about services Fear to visit Hospital alone Health System Factors Expensive health care Overcrowded health facilities Unavailability of doctor Long waiting time Lack of laboratory facilities Improper attention of the health care staff Lack of space Hectic process of collecting lab-reports Medicines are not free Timings of health facility are not convenient Improper infrastructure Lack of specialist doctor Lack of positive attitude Community / Environment Factors Long distance from home to health facility Poor transportation facility Lack of family/community support Inability to take decision independently due to family/ culture

11 Lens 2 Availability Geographic Accessibility Long distance Poor transportation facility Unavailability of doctor Lack of laboratory facilities Lack of space Lack of specialist doctor Affordability Financial problem Expensive health care Medicines are not free Acceptability (Awareness) Reluctant towards selfcare Lack of knowledge about diseases Overcrowded health facilities Lack of knowledge about services Long waiting time Improper attention of the health care staff Inability to take decision independently Hectic process of collecting lab-reports Improper infrastructure Improper treatment Timings of health facility are not convenient Fear to visit Hospital Lack of positive attitude

12 Percet percent Overall barriers reported to access healthcare services by the respondents Geographic Accessibility Availability Affordability Acceptability Individual Health System Community/Environment Source: Shimla Results, Phase I Medtronic-MAMTA

13 Prioritization - ACTION Community level: Community (including patient) empowerment Health System level: At Primary Health care level -- Strengthen structure (HR & Infrastructure) of the healthcare services. At Secondary/tertiary care level -- Simplification of the healthcare delivery process.

14 Outline Intervention Framework and Key Activities 12/8/

15 Intervention Framework for Change Intervention Frontline functionaries Enhanced capacity of frontline functionaries in delivering NCD care - Improved timely access to health facilities -Improved treatment compliance Reduction in Premature morbidity & mortality People in the community Intervention Empowered individuals and their family/care givers -Reduction in out-ofpocket expenditure Intervention Target Beneficiary Intermediate outcome Final outcome Impact

16 Population (Age 15-70) Risk Assessment Healthy Stay healthy At Risk Obj 2- Increasing management and control of Diabetes or CVD Diseased Obj 1- Increasing diagnosis Treatment & Behaviour Compliance Capacity Building of health workforce CM for early diagnosis BCC for lifestyle modification Patient group meeting and peer group counselling Self management skills thru mhealth Group meetings with families and caregivers Patient tracking for clinical parameters E-clinic for expert advise Training and refresher training Mentoring support Advocacy for regular supply of drugs and materials Sensitization and motivation for early diagnosis Regular followup Customised counselling using mhealth and paper based education material E-clinic for expert advise

17 Medical College District Hospital CHC PHC Sub Center Individuals seeking care

18 No proper channel of referral up the chain Medical College District Hospital CHC PHC Sub Center Individuals seeking care

19 No proper channel of referral up the chain Medical College District Hospital CHC PHC Sub Center Individuals seeking care

20 No proper channel of referral up the chain Medical College District Hospital CHC PHC Sub Center Individuals Mobile App seeking care

21 IVRS No proper channel of referral up the chain Medical College District Hospital CHC PHC Sub Center Individuals Mobile App seeking care

22 IVRS E-clinic No proper channel of referral up the chain Medical College District Hospital CHC PHC Sub Center Individuals Mobile App seeking care

23 IVRS E-clinic No proper channel of referral up the chain Medical College District Hospital CHC PHC Sub Center Individuals Mobile App seeking care

24 IVRS E-clinic No proper channel of referral up the chain Medical College District Hospital CHC PHC Sub Center Individuals Mobile App seeking care

25 Technology solution responses Solution How will the project benefit? Who are the beneficiaries? Mobile app - About disease - Am I at risk - Goal tracker IVRS -Facilitate appointments with specialists (a) Increase disease literacy (b) Self Mgmt skills (a) Early decision to seek care (a) At risk (b) Patient (a) At risk (b) Patient E-clinic -Consultation with Specialist -Follow up services (a) Early decision to seek care (b) Treatment adherence and behavior compliance (a) At risk (b) Patient

26 Unique value Aligned with National Government Plan Sustainable technology based low-cost solution Intervention design evidence and need based Participatory approach

27 Outline Timeline for next 6 months

28 Apprise State Government about the project and ensure their concurrence and participation Development of Intervention Protocol: Conduct Rapid situational analysis for identifying opportunities to integrate e- clinic, m-health technology into existing system (health, education and local governance). Design of Intervention Protocol based on situational analysis. Recruitment of project staff at state and district level and their training about intervention protocol including M&E framework Content development: Risk Assessment Tool Training manual IEC material for frontline functionaries Development of mobile app, IVRS and prescription software for e-clinics Operational testing and finalization of mobile app and IVRS application in the field. 28

29 Sensitization meetings with key opinion leaders Mapping of communities and health facilities(public, private and others) Risk Assessment and screening of the target population for diabetes and hypertension using RA tool Radio campaign-defining audience, key message development, finalisation of communication channels Establishment of e-clinic, Development of prescription software, pilot testing Advocacy meeting to enable patient support mechanisms with different government departments Monitoring and supervision 29

30 Key Project Staff Project Director Project Manager M&E Manager Medical Specialist State Programme Manager Manager (eclinic) District Coordinator Outreach Worker 30

31 Key Partner Purposive selection - Government medical college with associated hospital - Have collaborated and worked in the past - Willingness to collaborate with MAMTA Role of Indira Gandhi Medical College, Shimla, Himachal Pradesh (a) Technical (medical) support - laboratory services for diagnosis - care and treatment - management of complications (b) Operational support - execution of services through health centres run by department of community medicine, IGMC 31

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